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Biomedical subjects

Jack L Lesher

Publications and source records attributed to Jack L Lesher.

16 recordsLinked to original sources
PubMed2005

Unilateral Basal cell carcinomas: an unusual entity treated with photodynamic therapy.

BACKGROUND: Unilateral localized basal cell carcinomas are an uncommon finding that presents both a diagnostic and therapeutic challenge. Exclusion of unilateral nevoid basal cell carcinoma syndrome is indicated. There are few reports in the literature regarding this entity and even less regarding therapeutic strategies. OBJECTIVE: We present a patient with unilateral localized basal cell carcinomas who was successfully treated with photodynamic therapy. METHODS: Photodynamic therapy was started using Levulan) Kerastick) as previously described. The topical solution was applied to the patient's back and illuminated the following day via the BLU-U Blue Light Illuminator. RESULTS: The patient tolerated the procedure well and without complications. The patient had an excellent therapeutic response with no clinically apparent basal cell carcinomas for 18 months. CONCLUSIONS: We report a patient with unilateral basal cell carcinomas successfully treated with photodynamic therapy. This uncommon entity represents a diagnostic challenge in its inherent absence of the classic clinical and radiographic findings of nevoid basal cell carcinoma syndrome. Like nevoid basal cell carcinoma syndrome, unilateral basal cell carcinomas poses a therapeutic challenge with the sheer number of cutaneous tumors. The use of photodynamic therapy carries a proven therapeutic efficacy, a low rate of adverse events and excellent cosmesis.

Aminolevulinic Acid↗
PubMed2005

Tuberous and tendinous xanthomata secondary to ritonavir-associated hyperlipidemia.

Xanthomas most often occur in conjunction with a primary or secondary disorder of lipid metabolism. A range of metabolic disturbances has been described in association with protease inhibitors, including lipodystrophy, hyperglycemia, and hyperlipidemia. Ritonavir has been repeatedly shown to be the most common protease inhibitor to induce these metabolic abnormalities. This report highlights a case of both tuberous and tendinous xanthomata secondary to ritonavir-associated hyperlipidemia.

HIV Infections↗
PubMed2005

The effect of sunless tanning on behavior in the sun: a pilot study.

BACKGROUND: In the United States, indoor tanning is a booming industry and contributes to the ultraviolet light (UVL) burden that ultimately leads to skin cancer. "Sunless" tanning methods that avoid UVL exposure may represent a safe alternative. However, the effects of sunless tanning methods on ultraviolet light-related behaviors have never been investigated. METHODS: Anonymous survey of 121 individuals who underwent a spray-on sunless tanning treatment between February and May 2004. RESULTS: Women completed 107 surveys. Men completed 14 surveys. The majority of individuals reported that they had not or would not change their time spent outdoors or their sunscreen use as a result of undergoing sunless tanning. However, 73% of individuals who had used UVL tanning beds said they had decreased or would decrease their UVL tanning bed use. CONCLUSION: Sunless tanning is associated with a self-reported decrease in traditional UVL tanning bed use among tanning bed users. Physicians should advocate the use of sunless tanning to their patients who use traditional UVL tanning beds as a means of decreasing their UVL exposure and cancer risk.

Adolescent↗
PubMed2004

Pyogenic granuloma arising within a port-wine stain.

Pyogenic granulomas are common overgrowths of vascular tissue that usually arise on the face, lips, or hands after episodes of minor trauma or during pregnancy. Pyogenic granulomas rarely have been reported to arise in congenital capillary malformations such as port-wine stains, a presentation that most often occurs after laser treatment of port-wine stains or in the setting of pregnancy. This co-occurrence of the 2 lesions represents an underreported event, and the presentation can be alarming or mimic malignancy when there is no prior history of trauma or other known circumstances in which pyogenic granulomas occur. We report a case of a pyogenic granuloma emerging within a port-wine stain in a 35-year-old man with no predisposing factors. A review of the literature regarding pyogenic granulomas that arise within port-wine stains is presented and yields informative conclusions regarding the clinical scenarios where this sometimes alarming event is likely to happen.

Adult↗
PubMed2004

Deep venous thrombosis after high-dose intravenous immunoglobulin in the treatment of pemphigus vulgaris.

A 43-year-old black man with pemphigus vulgaris was started on intravenous immunoglobulin (IVIg) therapy after his disease was found to be refractorry to prednisone alone and prednisone in combination with mycophenolate mofetil, azathioprine, methotrexate, cyclosporine, and oral cyclophosphamide. The patient subsequently developed a deep venous thrombosis (DVT) that was attributed to the IVIg. IVIg has been associated with numerous thrombotic complications such as pulmonary embolism and myocardial infarction. Traditional risk factors for thrombotic complications, such as hypertension, a history of coronary artery disease, and immobility, should be considered as relative contraindications to IVIg therapy.

Adult↗
PubMed2002

Tibialis anterior muscle herniation.

BACKGROUND: Tibialis anterior herniation occurs through a defect in the deep fascial layer of the lower extremity. While this entity is not uncommon, it has been rarely reported in the dermatologic literature. OBJECTIVE: To highlight the occurrence of tibialis anterior herniation and its presentation and treatment. METHODS: Case report. RESULTS: We present a case of tibialis anterior herniation in a patient who presented with asymptomatic nodules in her lower extremities. The nodules were flesh-colored, soft, and compressible with palpation. CONCLUSION: The diagnosis of tibialis anterior herniation should be considered in patients with positionally variable subcutaneous nodules, especially in the lower extremities. It is caused by a defect in the deep fascial layer and often involves the lower extremities. In addition, knowledge of the diagnosis and treatment is essential for both proper management and/or surgical referral.

Adult↗
PubMedDate not supplied

Bilobed thumbnails with erythronychia.

Onychodystrophy is a common problem and may have multiple causes, both internal and environmental. We present an unusual nail finding in a gentleman without any identifiable etiology. He and several family members had isolated notching of the thumbnails with a characteristic erythematous band.

Aged↗
PubMedDate not supplied

Keratosis pilaris atrophicans: case series and review.

Keratosis pilaris atrophicans is a group of three rare and distinct clinical entities representing the scarring types of keratosis pilaris. To date, our complete understanding of these processes and therapeutics are suboptimal. This case series illustrates unique aspects of each entity and offers a review of the literature.

Adult↗
PubMedDate not supplied

An unusual case of factitious onychodystrophy.

Nail disorders are a common dermatologic problem, and when such disorders are self-induced, the diagnosis and treatment can be challenging. We present an unusual instance of factitious onychodystrophy with associated erythronychia of the nail bed.

Child↗
PubMedDate not supplied

Furuncular myiasis secondary to Dermatobia hominis.

Dermatobia homininis is the most common cause of furuncular myiasis in Central and South America. It is diagnosed based on a history of travel to an endemic region and the characteristic cutaneous lesion. We present a 54-year-old patient who presented with both a travel history and cutaneous findings of furuncular myiasis.

Animals↗